Calculate a support stack for GLP-1 medications (semaglutide / Ozempic / Wegovy, tirzepatide / Mounjaro / Zepbound, liraglutide / Saxenda). Addresses the five most common nutritional gaps: dehydration, muscle loss, B12 depletion, constipation, sarcopenia risk. Math, not medical advice — coordinate with prescriber.
Your situation
| Component | Daily target | Form | Notes |
|---|
Why each component matters on GLP-1s
- Protein (1.4-2.0 g/kg goal body weight): the #1 priority. Without adequate protein, fast weight loss = 25-40% muscle loss. Whey isolate or plant blends work — small frequent servings tolerate better than large meals.
- Electrolytes (Na 1500-3000 mg, K 2000-3500 mg, Mg 300-500 mg): reduced food = reduced electrolyte intake. Common symptoms (fatigue, dizziness, brain fog) often = electrolyte deficit, not the drug itself.
- Creatine (5g/day): hard floor for muscle preservation. Cheap, well-tolerated, evidence-strong in caloric deficit + resistance training combination.
- B12 (500-1000 mcg/day): proton pump inhibitor + reduced food intake = absorption issues. Sublingual or methylcobalamin preferred. Check serum B12 + MMA at 6 months.
- Fiber (psyllium or partially-hydrolyzed guar gum): constipation is the #1 side effect. Soluble fiber preferred (avoids GI distress that insoluble fiber can trigger).
What also matters but isn’t on the supplement list
- Resistance training 2-3x/week: the single most important factor for preserving lean mass. Supplements without training = much less effective.
- Adequate sleep (7+ hours): cortisol management during caloric deficit. Sleep deprivation increases muscle catabolism.
- Hydration (35 ml/kg as starting point): reduced appetite often reduces thirst signals. Drink to schedule, not thirst.
- Multivitamin (basic): insurance against general micronutrient gaps when food intake is reduced.
- Vitamin D (1000-4000 IU): often deficient pre-existing in obesity; supplementation worthwhile.
Hair loss and rapid weight loss
- Telogen effluvium commonly occurs 3-6 months after starting GLP-1s, even with adequate nutrition. Caused by metabolic stress + rapid composition change.
- Usually self-limiting (resolves in 6-12 months once weight stabilizes).
- Worth checking: ferritin (over 70 ng/mL for hair), vitamin D (over 40 ng/mL), zinc, B12.
- Hair-specific stack: biotin 5000 mcg (but pause 3 days pre-thyroid labs), collagen 10-20g, omega-3 1-2g, iron only if low.
What NOT to supplement on GLP-1s
- High-dose calcium without K2 + magnesium: calcium-only supplementation may carry CV risk. See bone-stack-calculator.
- Pre-workout stimulants (high caffeine): GLP-1s slow gastric emptying — heavy pre-workout may cause severe nausea.
- Berberine (as glucose-lowering add-on): theoretical hypoglycemia risk if also on GLP-1. Discuss with prescriber.
- High-dose chromium: insulin sensitization theoretically additive with GLP-1 effects. Probably fine but unnecessary.
- Bitter melon / fenugreek (other glucose-lowering herbs): redundant + interaction risk.